title: Determination of the time for maximal response to neoadjuvant hormone therapy for prostate cancer using magnetic resonance with spectroscopy (MRSI) and dynamic contrast enhancement (DCEMR).
abstract: OBJECTIVE
  To determine the time-dependent metabolic and angiogenic changes that occur in prostate cancer (CaP) during neoadjuvant hormone therapy (HT), using a combination of MRSI and DCEMR analysis.
  
  
  METHODS
  This is a prospective study on a population of non-metastatic CaP submitted to neoadjuvant HT prior to radiation therapy. All cases homogeneously received a 6-month period of neoadjuvant HT using leuprorelin acetate 7.5 mg every 28 days. In all cases, a MRSI/DCEMR study was performed at baseline (pretreatment) and at regular intervals (4, 12, 24 weeks) during HT. Serum PSA was measured at baseline and at the same intervals (4, 12, 24 weeks). All MRI examinations were performed on a commercially available 3 T scanner.
  
  
  RESULTS
  There was a significant ( P < 0.01) time-dependent loss of all prostate metabolites during HT. In regions of CaP no significant variation in the absolute value of metabolites was reported at 1-month interval and a higher variation was observed at 24-week compared with 12-week interval. A complete metabolic atrophy was a common feature (30%) at a 24-week interval of HT, but not at short (4-week 0%), and lower at an intermediate interval (12-week 10%). At DCEMR, onset time and time to peak parameters significantly (P < 0.05) increased at 12- and 24-week intervals.
  
  
  CONCLUSIONS
  To individualize neoadjuvant HT courses prior to definitive treatment, the combination of MRSI and DCEMR may represent a valid noninvasive method, and the addition to PSA data could be used to better assess the time-dependent efficacy of HT in our patients.
authors.affiliation: Department of Urology, University Sapienza of Rome, Rome, Italy. sciarra.md@libero.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sciarra
authors.forename: Valeria
authors.initials: V
authors.lastname: Panebianco
authors.forename: Stefano
authors.initials: S
authors.lastname: Salciccia
authors.forename: Danilo
authors.initials: D
authors.lastname: Lisi
authors.forename: Andrea
authors.initials: A
authors.lastname: Alfarone
authors.forename: Alessandro
authors.initials: A
authors.lastname: Gentilucci
authors.forename: Ulderico
authors.initials: U
authors.lastname: Parente
authors.forename: Susanna
authors.initials: S
authors.lastname: Cattarino
authors.forename: Roberto
authors.initials: R
authors.lastname: Passariello
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Gentile
mesh_terms: D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D016729:Leuprolide / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D017063:Outcome Assessment, Health Care / Q000379:methods; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D018931:Antineoplastic Agents, Hormonal; D017430:Prostate-Specific Antigen; D016729:Leuprolide